Prospective Collaborative Program In Neuroscience (CPIN) students may fill in and submit the below application form. All applications must include the completed CPIN Student Application Signature Page that can be found at this link

To ensure that the form has been received by us, please wait for a confirmation message upon submission. We recommend Google Chrome or Mozilla Firefox to fill the form.

Before being admitted into CPIN, a student must be registered in a home graduate unit. To view a list of participating units, click here.

Students must meet all program requirements as listed on the website in order to graduate with the CPIN Notation on their transcript, no exceptions. Click here for details.

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Student Information First Name: Last Name: Student Number: Department: Applied Psychology and Human DevelopmentBiochemistryCell and Systems BiologyComputer ScienceDentistryInstitute of Biomaterials and Biomedical EngineeringInstitute of Medical ScienceLaboratory Medicine and PathobiologyMedical BiophysicsMusicPharmacology & ToxicologyPharmaceutical SciencesPhysiologyPsychologyPublic HealthRehabilitation ScienceOther Degree Program: MAMAScMScPhD SGS Registration Date: Student E-mail Address:  Enter a valid email address. Example: name@company.com Title/Topic of Research: Expected length of study (years): Supervisor's Name: Supervisor's E-mail Address:  Enter a valid email address. Example: name@company.com LAB ADDRESS Address: Institution: City: Province: Postal Code: Phone Number:  Enter a valid phone number. Example: 123-456-7890 HOME ADDRESS Address: City: Province: Postal Code: Phone Number:  Enter a valid phone number. Example: 123-456-7890 Signature Page Please attach your completed CPIN Student Application Signature Page here (see above for download link): If you do NOT wish to be listed on the CPIN website, please check box: